Background: In Italy patients are supposed to choose their primary care physician (PCP), but many prefer to attend specialists or hospitals. To understand the patients' decision processes regarding selection of PCP, their attitudes, perceptions and related behaviours on the role of PCPs in Italy were investigated.
Methods: A random sample of parents received a questionnaire concerning information on demographic and socio-economic characteristics, health status, utilization of health services, attitudes and behaviours towards PCPs.
Results: A total of 387 (48.4%) subjects participated in the study. Of the sample subjects, 70% had attended a PCP in the previous year, 45% a specialist, and 40% a hospital. Reasons for not attending a PCP were absence of health problems (52.5%), preference for specialists (18.8%), and self-care (17.5%). For almost all responders (88.8%) the first medical person they attended regarding health problems was the PCP, mainly because of confidence in professional skills (45.1%), satisfaction regarding the interpersonal relationship (25.8%), easy access to visit (14%), and medical prescriptions (14%). Patients were significantly more willing to visit a PCP if they were of lower education level and had visited a PCP in the previous year; those who preferred a PCP to present severe health problems were significantly more likely to be young, not affected by a chronic disease, and had attended a PCP in the previous year.
Conclusions: The majority of patients perceived the role of PCPs as 'gate-keepers' and further research is needed to explore how PCPs' attitudes and behaviour can enhance patients' trust in primary health care.